Journal List > Ann Clin Microbiol > v.23(1) > 1144295

Choi, Kim, Jang, Cho, Jang, Ko, Kang, and Park: Role of Efflux Pump Gene adeIJK to Multidrug Resistance in Acinetobacter baumannii Clinical Isolates

Abstract

Background

The emergence of multidrug-resistant Acinetobacter baumannii as a nosocomial pathogen is one of the major public health problems. The aim of this study was to evaluate the role of an efflux pump gene adeJ for the multidrug resistance ofA. baumannii clinical isolates.

Methods

Two groups (MDRAB and SAB) of A. baumannii clinical isolates were studied. The SAB group consisted of strains that did not meet the criteria of MDRAB and were susceptible to more categories of antibiotics than MDRAB. Antimicrobial susceptibility results obtained by VITEKⅡ system were used in data analysis and bacterial group allocation. We performed real-time reverse transcription PCR to determine relative expression ofadeJ. We compared relative expression of adeJ in comparison groups by considering two viewpoints: i) MDRAB and SAB groups and ii) susceptible and non-susceptible groups for each antibiotic used in this study.

Results

The mean value of relative expression of adeJ of MDRAB and SAB groups was 1.4 and 0.92, respectively, and showed significant difference (P=0.002). The mean values of relative expression of adeJ of susceptible and non-susceptible groups to the antibiotics cefepime, ceftazidime, ciprofloxacin, imipenem, meropenem, tigecycline, piperacillin/ tazobactam, ticarcillin/clavulanic acid, trimethoprim/sulfamethoxazole, piperacillin, and gentamicin showed statistically significant differences.

Conclusion

The overexpression ofadeIJK might contribute to the multidrug resistance inA. baumannii clinical isolates. Further, the overexpression ofadeIJK might be one of the factors contributing to the resistance to numerous antibiotics.

References

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Fig. 1.
Relative expression of the adeJ efflux pump gene determined by real-time reverse transcriptase PCR in A. baumannii type strain (ATCC19606), multidrug resistant A. baumannii AYE strain, 70 strains of multidrug resistant A. baumannii (MDRAB) and 30 strains of non-MDRAB clinical isolates. The normalized expression of adeJ was calibrated with the expression of A. baumannii ATCC 19606. The error bars represent the standard error of the mean. *P < 0.05.
acm-23-45f1.tif
Fig. 2.
Relationship between adeJ pump gene expression and resistance to each antibiotics. Relative expression of adeJ efflux pump gene in non-susceptible (NS) group was higher than that of susceptible (S) group to each antibiotics in general. The statistically significant difference was found between S and NS groups to cefepime, cefotaxime, ceftazidime, ciprofloxacin, gentamicin, imipenem, meropenem, piperacillin, piperacillin/tazobactam, ticarcillin/clavulanic acid, tigecycline, and trimethoprim/sulfamethoxazole, respectively. *P < 0.05, **P < 0.001. The error bars represent the standard error of the mean.
acm-23-45f2.tif
Table 1.
Oligonucleotide primers used in this study
PCR Gene Primer Sequences (5' → 3') AT References
Conventional PCR gyrB Multiplex 1 Sp4F CAC GCC GTA AGA GTG CAT TA 60°C (11)
    Sp4R AAC GGA GCT TGT CAG GGT TA    
    Sp2F GTT CCT GAT CCG AAA TTC TCG    
  bla OXA51-like Oxa51-like F TAA TGC TTT GAT CGG CCT TG 55°C (12)
    Oxa51-like R TGG ATT GCA CTT CAT CTT GG    
Real-time RT-PCR rpoB rpoB F CTC ACT ATG GTC GTG TTT GTC 57°C this study
    rpoB R CCA AGA AAC CGA AGT CAT TCG    
  adeJ adeJ F CAA GTT ATT GCA TTC TAT TCA CCA G 57°C this study
    adeJ R GAC CTG TAC CTC ACC AAC AC    

Abbreviation: AT, annealing temperature.

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